When the universe says ‘no’

Experts discuss common struggles with infertility and secondary infertility

If your baby-making dreams have become a nightmare, you aren’t alone. Infertility affects 7.3 million American women. And more than half of them have successfully given birth to one or more children. Secondary infertility happens when a couple cannot conceive a second (or third) child despite previous pregnancy.

Read more: How late is too late to start a family?

Conception concerns

There are many reasons for infertility, and it isn’t only a woman’s issue. The American Society of Reproductive Medicine attributes one third of cases to male factors, including sperm count or quality; one third to female factors, including ovulation disorders and endometriosis, Age, smoking, stress and obesity can increase infertility risk. One third of cases are due to a combination of factors or to unknown causes.

Melissa Ford, author of “Navigating the Land of If: Understanding Infertility and Exploring Your Options,” likens infertility to the Bermuda Triangle.

“The physical, emotional, and financial stressors of infertility are intense,” Ford says, “and it’s easy to get lost.”

Most couples take one step at a time, venturing deeper into the unknown as they go. Each couple has to find their own way out.

Read more: Experts discuss stress and fertility

Pathways out of infertility

Infertility might be simpler if there were only one way out. But, there are many options, Ford says, and it’s helpful to explore them with your physician as your journey unfolds.

Many couples start with the least invasive options — fertility medications and intra-uterine insemination — before moving to more invasive (and more costly) procedures like in vitro fertilization.

Depending on the causes of infertility, the use of donor eggs, sperm or embryos or a surrogate may be warranted. Some couples opt for adoption from the beginning, and others choose adoption after other treatments fail. If you’re considering donors, surrogacy or adoption, consult a reproductive attorney for advice.

Some infertile couples choose to live childfree, says Constance Shapiro, PhD, therapist and author of “When You’re Not Expecting: An Infertility Survival Guide.” They move past the grief they feel and commit to a life that doesn’t include kids. The emotional journey from feeling childless to being childfree opens the door to other possibilities, but it isn’t easy.

Stresses of infertility

Not long after “I Do,” people start asking “When are you going to start a family?” Our society reinforces the idea that a family consists of two parents and their children and people internalize that model, Shapiro says. When infertility threatens that ideal, it hurts.

Treatment is stressful, too. Doctor’s appointments are inconvenient, and fertility drugs can cause mood swings and weight gain. Treatments are expensive, and many couples take out loans to finance baby-making, Ford says.

Feedback throughout the process — about hormone levels, follicle development, and (you hope) pregnancy — is a double-edged sword. Each bit of bad news crushes you a little more.  

Read more: 5 key facts that can increase your chances of pregnancy

Seeing others have babies can magnify the disappointment couples feel. When friends show off their sonograms and ask for baby-naming advice, you may feel angry and jealous. Infertility can be isolating, especially if it’s a secret.

To top it off, when you’re struggling to get pregnant, sex isn’t so sexy, Shapiro says. Treatments may require intercourse at specific times in the menstrual cycle and forbid it at other times. Couples may miss the intimate physical connection they once experienced.  

There is no easy way out of infertility. It’s normal to feel an enormous loss when your dreams for the future don’t come true. “Before infertility, I had never encountered a ‘no’ from the universe,” says Ford. “All the big life events came easy. Infertility made me realize how much is out of my control.” Now a mother of twins, Ford says she’s learning that lesson over and over in parenting.

Heidi Smith Luedtke is a personality psychologist and mother of two. She is the author of Detachment Parenting.

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• In the United States, 15 percent of all couples will face infertility issues, and many will be diagnosed with a reproductive disorder.

• Infertility is not just a woman’s problem. In about 50 percent of couples, sperm disorders or male factors cause infertility.

• More than 3 million people in the U.S. experience difficulty getting pregnant after baby #1. 

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These phrases may sound sympathetic, but they’re likely to do more harm than good, says licensed clinical psychologist Robin Goodman, PhD. If you know someone who is struggling with infertility, don’t say:

“I know how you feel” (Everyone is different. Even if you did go through something similar, find out how they feel.)

“It’s for the best” (This is not comforting even if you think it is true. Your friend is grieving for the future she imagined for her family.)

“At least you have each other” (This may be true. But a partner — or a pet or a job — can’t replace a child.)

“You can always adopt” (Some couples desperately want to have their own biological children.)

“The baby would probably not have survived” (Even in cases of early miscarriage, your friend may feel overwhelming loss. Don’t minimize it.)

Read more: How infertility treatment affects oral health

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• Acknowledge your sadness. Share your feelings with each other, but don’t be consumed by negativity. Put limits on when and where you will discuss emotions. And don’t do it in the bedroom!

• Ration your energy. If baby showers and kid-focused conversations are weighing you down, it’s okay to opt out sometimes. Friends and family will understand. Participate in social events how and when you can.

• Be united. For most couples, infertility is too heavy an emotional load to shoulder between just the two of them Working through who to tell and how much to share can increase your emotional intimacy. Treat infertility as a couple’s issue and stay connected.

• Seek support. Don’t let infertility tear you down. Join an online community or get counseling. Many clinics have psychologists on staff and most use sliding fee scales, Shapiro says. Reach past the isolation and get help.

— Compiled with tips from Melissa Ford, author of “Navigating the Land of If: Understanding Infertility and Exploring Your Options,” and Constance Shapiro, PhD, therapist and author of “When You’re Not Expecting: An Infertility Survival Guide”